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Journal of Hand and Microsurgery

Ahmadreza Afshar
No abstract text is available yet for this article.
December 2017: Journal of Hand and Microsurgery
Ahmadreza Afshar
No abstract text is available yet for this article.
December 2017: Journal of Hand and Microsurgery
Reid W Draeger, Donald K Bynum, J Megan M Patterson
Cable nerve grafting is the recommended surgical treatment for large peripheral nerve defects. Traditionally, this is performed by bridging a gap in the nerve with multiple autologous nerve cables, repairing the epineurium of each cable to the perineurium of a fascicle of the injured nerve that is similar in size to the graft. The authors present a new technique in which they used nerve-cutting guides to aid in the placement of fibrin glue to secure the sides of the cabled nerve graft together to facilitate handling of the cabled nerve graft and to expedite repair...
December 2017: Journal of Hand and Microsurgery
Michael V DeFazio, Kevin D Han, Ebrahim Paryavi
Successful replantation of distal digital segments necessitates the establishment of sufficient outflow to minimize congestion and progressive tissue necrosis. In cases where only arterial anastomosis is feasible, an artificial outlet must be provided to maintain physiological requirements until microvenous circulation regenerates. This can be accomplished using any number of "exsanguination techniques" designed to facilitate egress through ongoing passive blood loss. Although reportedly effective, these measures are imprecise and carry a substantial risk of infection, scarring, and/or uncontrolled hemorrhage...
December 2017: Journal of Hand and Microsurgery
Daniel P Carpenter, Reid W Draeger
We report a case of severe upper extremity complex regional pain syndrome type 1 (CRPS-1) and neurogenic edema that ultimately led to a medically necessary below-elbow amputation. The patient presented with a history of remote bilateral carpal tunnel release complicated by debilitating and recalcitrant bilateral CRPS-1. Following years of severe neurogenic edema of the left upper extremity, the patient had full-thickness skin sloughing on the dorsum of her hand due to massive edema. This subsequently led to maggot infestation of the soft tissues of the left hand ultimately necessitating amputation...
December 2017: Journal of Hand and Microsurgery
Antonio Andreacchio, Flavia Alberghina, Vanessa Giacometti, Lorenza Marengo, Federico Canavese
Intraosseous hemangiomas are uncommon benign vascular tumors. Here the authors report a case of intraosseous hemangioma of the radial shaft in a 2-year-old boy, surgically treated by tumor mass resection and application of calcium sulfate pellets with no signs of relapse over a 2-year follow-up. Moreover, the lesion healed with new bone formation, and the last plain radiographs suggested homogenous normal trabecular bone density. The radius grew in length and remodeled to an almost normal shape. Clinically, elbow flexion-extension and forearm pronation and supination were within normal limits at the last follow-up visit...
December 2017: Journal of Hand and Microsurgery
Maryam Farzad, Fereydoun Layeghi, Seyyed Ali Hosseini, Khanke Hamidreza, Ali Asgari
Background  Although participation is a core concept in multiple models of disability, there is no consensus on its definition. Objective  The aim of this study was to extract participation domains based on review of theories, available outcome measures, and interviews with experts and the person with hand injuries to compare with the ICF domains of participation. Methods  A qualitative approach using a deductive content analysis was employed to extend definitions of participation from theories. Later on, inductive qualitative method using semistructured interview with five experts in different fields and 30 patients with different hand injuries was used...
December 2017: Journal of Hand and Microsurgery
Constantinos Ketonis, Noreen J Hickock, Asif M Ilyas
Introduction  Pyogenic flexor tenosynovitis (PFT) of the hand remains a challenging problem that often requires surgical irrigation and parenteral or oral antibiotics. The authors hypothesize that the pathophysiology and microenvironment of PFT can be likened to that of periprosthetic joint infections (PJIs), in which bacteria thrive in a closed synovial space with limited blood supply. As such, they postulate that PFT is also facilitated by bacterial attachment and biofilm formation rendering standard treatments less effective...
December 2017: Journal of Hand and Microsurgery
Jamie L Engel, Joseph N Gabra, Andrew R Esterle, William D Lanzinger, John J Elias
Purpose  The current study compares the strength of a previously studied technique for flexor tendon repair with barbed sutures to an experimental approach that aligns all the barbs to oppose distraction. Methods  Twelve flexor tendons from cadaveric specimens were mechanically tested following repair of simulated zone II tendon injuries. Two repair techniques utilizing barbed sutures were studied: the Marrero-Amadeo four-core barbed suture approach and the experimental configuration with all barbs on four cores opposing distraction...
December 2017: Journal of Hand and Microsurgery
Abdul Nawfar Sadagatullah, Ahmad Sukari Halim, Mohd Shakir Bathusha, Anantha Kumar Ramachandran
Background  The possibility of a person who had undergone surgery to be exposed to the ill effects of cigarette smoke is high, more so if the person lives with a smoker. With increasing popularity of reverse sural fasciocutaneous flaps, a surgeon may have to manage a person who lives with a smoker or is exposed to cigarette smoke. A clear understanding of the effects of exposure to cigarette smoke on reverse sural fasciocutaneous flaps is necessary. This study was performed to establish a clearer understanding of the effects of smoking on reverse sural fasciocutaneous flaps and evidence for preoperative patient counseling about smoking and smoke exposure...
December 2017: Journal of Hand and Microsurgery
Muhammad Mansha, Darren Flynn, John Stothard
Purpose  Percutaneous needle fasciotomy is performed in the authors' department to treat Dupuytren's contracture at metacarpophalangeal joints. This study aimed to establish its safety and efficacy, compared with standard fasciectomy. Materials and Methods  All patients who had this procedure performed over the study period were sent the validated British Society for Surgery of the Hand (BSSH) postal questionnaire assessing surgical outcome. Hand function and disability were assessed using the Patient Evaluation Measure (PEM)...
December 2017: Journal of Hand and Microsurgery
Hui-Kuang Huang, Jung-Pan Wang
Electrosurgery using a bipolar cautery is very common, especially in surgical fields with surrounding vital structures. However, the tissue tends to stick to the bipolar forceps due to the heat cautery, which makes the tips stick together. When forceps tips are stuck to the cauterized tissue, surgeons have to spend time separating the tips. Also, when surgeons separate the tips, a cauterized bleeder may rebleed. Some bipolar forceps with nonstick coatings have been developed to reduce the sticking problem. However, for some surgeons or institutes, these nonstick bipolar forceps may be unavailable...
August 2017: Journal of Hand and Microsurgery
Dariush Nikkhah, Wojciech Konczalik, Tiew Chong Teo
No abstract text is available yet for this article.
August 2017: Journal of Hand and Microsurgery
Luigi Tarallo, Raffaele Mugnai, Fabio Catani
No abstract text is available yet for this article.
August 2017: Journal of Hand and Microsurgery
Wojciech Konczalik, Amir H Sadr, Dariush Nikkhah
No abstract text is available yet for this article.
August 2017: Journal of Hand and Microsurgery
James D Kotick, Roger S Sandelin, Richard D Klein
The use of pedicled and free flaps for tissue transfer and coverage has become a common practice in modern plastic surgery. An area that presents considerable challenge for tissue coverage is the groin. Defects in this area are complicated by issues such as prior surgery; scar contracture; extension of the defect beyond the borders of the groin; radiation damage; high probability of infection; and involvement of vital underlying structures, the genitalia, and perineal and perianal area. Therefore, the choice of donor site and flap usage is often difficult...
August 2017: Journal of Hand and Microsurgery
James D Kotick, Amir Taghinia
Use of the medicinal leech in microsurgery is common place for venous decongestion and can be associated with the need for transfusion over time and multiple applications. Here the authors present a case of profound, ongoing, life-threatening bleeding after a single leech application in pediatric microscopic surgery. There are no reports of such profound bleeding in the literature, and this case serves as a warning of the need for close surveillance in this subset of patients.
August 2017: Journal of Hand and Microsurgery
Ali Tabrizi, Ahmadreza Afshar
During a taekwondo competition, a 20-year-old female competitor injured her left thumb. There was pain, swelling, and tenderness at the ulnar side of the metacarpophalangeal joint. Plain radiography demonstrated an avulsion fracture with a small-size fragment at the base of the proximal phalanx. A mini hook plate was used to repair the lesion. The patient was satisfied with the results and returned to her sports activities after 2 months.
August 2017: Journal of Hand and Microsurgery
Masahiro Tatebe, Shiro Urata, Kenji Tanaka, Toshikazu Kurahashi, Shinsuke Takeda, Hitoshi Hirata
Revascularization of damaged limbs/digits is technically feasible, but indications for surgical replantation remain controversial. The authors analyzed the survival rate of upper limb amputations and the associated factors in different age groups. They grouped 371 limb/digit amputees (average age, 44 years; range, 2-85 years) treated in their hospital during the past 10 years into three groups based on age (young, ≤ 15 years, n  = 12; adult, 16-64 years, n  = 302; elderly, ≥ 65 years, n  = 57) and analyzed their injury type (extent of injury and stump status), operation method, presence of medical complications (Charlson comorbidity index), and survival rate...
August 2017: Journal of Hand and Microsurgery
Maryam Farzad, Fereydoun Layeghi, Ali Hosseini, Gale Whiteneck, Ali Asgari
Objective  The purpose of this paper was to report on the first step in the development of a new instrument to measure participation including the full range of its characteristics. Methods  The 30-item participation behavior questionnaire (PBQ) was developed from four main sources (a literature review of the theatrical basis of participation, available participation measures, and interviews with patients and experts about participation). Item selection and the reliability and validity of the measure were explored using Rasch measurement modeling for analysis...
August 2017: Journal of Hand and Microsurgery
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